Background:Maternal anemia, low birth weight, intrauterine growth retardation and premature births are complications associated with malaria in pregnancy (MIP). In order to prevent malaria, Wold Health Organization (WHO) recommends at least three doses of Sulphadoxine Pyrimethamine (SP) for Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp-SP3+) during the antenatal period. This study aimed to determine the prevalence and the health system determinants of uptake of three or more doses (IPTp 3+) in Busia County, Kenya. Methods:A facility-based cross-sectional study conducted at Busia County Referral Hospital between June and July 2023. Mothers' in the Maternity Unit with term deliveries were consecutively sampled. Data on health system factors was collected using interviewer administered semi-structured questionnaires and interview guides. The statistical significance of health system factors affecting IPTp-SP3+ was dertemined using the odds ratio (OR) and adjusted OR. Results:The prevalence of IPTp-SP 3+ uptake was 43.0%. Health system factors significantly associated with IPTp-SP 3+ uptake were facility being too far (aOR = 0.575, 95% CI: 0.351- 0.941, p = 0.028) and waiting time being too long (aOR = 0.606, 95% CI: 0.385-0.955, p = 0.031). Conclusion:Prevalence of uptake of IPTp 3+ is still low, with less than half of the pregnant mothers complying. The County and National Ministries of Health should make a concerted effort to ensure availability and affordability of SP drugs and also ensure access to and customer satisfaction at the healthcare facilities.
Background: Skin and soft tissue infections (SSTIs) are conditions resulting from the inflammatory microbial invasion of the epidermis, dermis and sub-cutaneous tissue. They are very common infections, being the second most common indication for antibiotic prescription.Objective: To determine the antimicrobial susceptibility of bacterial organisms causing SSTIs and the antimicrobial management of SSTIs at the Moi Teaching and Referral Hospital (MTRH).Design: A cross sectional descriptive study.Setting: The study was carried out at Moi Teaching and Referral Hospital in Eldoret, KenyaSubjects/Participants: Patients admitted at MTRH, whose primary diagnosis was a bacterial SSTI (cutaneous abscess, purulent cellulitis and wound infection), identified based on clinical criteria.Result: Out of 84 bacteria cultured, Staphylococcus aureus constituted 47.6%. Methicillin Resistant Staphylococcus aureus (MRSA) constituted 45% of Staphylococcus aureus. Over 80% of Staphylococcus aureus were susceptible to vancomycin and ceftazidime. Likewise, other gram-positive bacteria, including Enterococcus spp., coagulase negative staphylococci and Streptococcus pyogenes were susceptible to vancomycin and clindamycin. Gram-negative bacteria were 25, and most were susceptible to meropenem and amikacin (>80%). However, Acinetobacter baumanii were not susceptible to any antimicrobial tested. Flucloxacillin and metronidazole were most used as empiric therapy, which was effective against the etiologic bacteria in 18%.Conclusion: The most common cause of SSTIs was Staphylococcus aureus, which were susceptible to vancomycin and clindamycin. Gram-negative bacteria were susceptible to meropenem and amikacin. Most empiric therapy was not appropriate.
Objective: To determine the impact of and adherence to hydroxyurea use over a 6-month period on the frequency of blood transfusion among children (1-18 years) with sickle cell disease (SCD).Study design, setting and duration: A retrospective quasi-experimental study conducted in a public (Kenyatta National Hospital) and a private (Gertrude’s Garden Children Hospital) hospital setting in Kenya from February to May 2017.Subjects: Participants were children aged 1-18 years with a diagnosis of sickle cell anaemia confirmed by serum electrophoresis who had been on hydroxyurea treatment for at least 6 months.Interventions and outcomes: The main intervention and outcome measures were hydroxyurea treatment and frequency of blood transfusion respectively.Results: A total of 64 children were studied. The mean age was 7.6 years (SD ±3.7). The mean decrease in the number of blood transfusions during the 6–12-month period after adequate use of hydroxyurea was 0.9 (95% CI 0.7 - 1.2; p < 0.001). Majority of the participants received hydroxyurea dosages of < 20mg/kg/day (51/64; 79.7%), took hydroxyurea as per the prescription (50/64;78.1%), and didn’t experience any side effects (56/64; 87.5%).Conclusion: This study suggests that hydroxyurea significantly reduces the frequency of blood transfusions in children aged 1-18 years with minimal sideeffects.
ABSTRACTBackgroundNeonatal bacterial infections have been associated with rising antimicrobial resistance levels. This has led to increasing neonatal morbidity and mortality in poorly resourced health facilities located in low income countries. Local studies on neonatal antibiotic sensitivity patterns and its associated risk factors could inform empirical antibiotic therapy and hospital infection control strategies.PurposeThe study aimed at determining the causative organisms, antibiotic sensitivity patterns and risk factors associated with neonatal sepsis at a tertiary teaching hospital in Western Kenya.Materials and MethodsCross-sectional study among neonates suspected to have sepsis and undergoing treatment at Moi Teaching and Referral Hospital (MTRH’s) newborn unit (NBU) between September 2017 and July 2018. Blood culture tests isolated bacteria and determined their antimicrobial sensitivity. Neonatal and maternal characteristics were obtained through medical chart reviews. Descriptive statistics, Pearson chi-square test of association and odds ratios were adopted.ResultsThe study enrolled 141 neonates, majority (57.4%) of whom were female. The median gestational age and birth weight were 37 (IQR: 22-45) weeks and 2400g (IQR: 800 - 4700) respectively. Of the 151 bacterial isolates identified, 46.4% were Klebsiella spp. followed by Coagulate negative staphylococcus (CoNS) at 27.8%. Klebsiella spp. was sensitive to meropenem, amikacin and cefepime but resistant to ceftriaxone, gentamycin and cefotaxime. However, CoNS was sensitive to vancomycin and penicillin. Both the neonatal and maternal risk factors assessed were not associated with neonatal sepsis.ConclusionThe main bacterial causes of neonatal sepsis were Klebsiella spp. and CoNS which were both sensitivity to meropenem and amikacin.
Background:HIV diagnosis is the gateway to antiretroviral therapy. However, 20-50% of HIV-infected individuals are unaware of their HIV status, derailing epidemic control.Objective:To increase awareness of HIV status and enrollment into HIV care & treatment (C&T) services through a national HIV testing services (HTS) rapid results initiative (RRI) campaign in Kenya.Design:This cross-sectional analysis presents yield of undiagnosed people living with HIV (PLHIV) and their enrollment into HIV C&T resulting from HTS RRI implemented in July-August 2013 as an example of utilizing RRIs to catalyze achievement of UNAIDS targets.Results:During the campaign 1,462,378 persons received HTS, of whom 220,902 (15%) were children (aged <15 years), 55,088 (7%) couples and 116,126 (8%) key populations. A total of 37,630 (2.6%) HIV+ individuals were identified. Among children who received HTS, 3,244 (1.5%) tested HIV positive, compared to 34,386 (2.8%) among adults. Of the eight regions in Kenya: Nyanza, Rift-valley and Nairobi contributed 73.3% of all HIV+ individuals identified. HTS at health facility settings yielded the highest proportion (69%) of HIV+ and key populations had the highest prevalence (4.8%). Of those infected, 29,851 (79.3%) were enrolled into HIV C&T. Sex, age and setting of HTS were significantly associated with enrollment into HIV C&T (p<0.0001).Conclusion:National HTS campaigns have the potential of increasing knowledge of HIV status. Targeted provision of HTS at health facility settings, to key populations and high burden geographical regions would narrow the gap of undiagnosed PLHIV towards achieving UNIADS 90-90-90 targets for HIV epidemic control.
Objective:This study aimed to translate, determine the comprehensibility and examine the linguistic equivalence of a Luganda Oral Mucositis Daily Questionnaire (OMDQ MTS) among patients undergoing chemotherapy.Design:This was a validation study design in which bilingual patients who were receiving chemotherapy at Uganda cancer institute and had experienced some sort of oral discomfort after the start of their treatment were asked to complete OMDQ MTS Luganda followed by the English version on the same visit. The tools were administered at least two hours apart and had different item order.Results and Conclusions:Fifty participants accepted to take part by completing both versions of OMDQ MTS data. All item mean score differences between the two versions were less than ±0.25. The Cronbach's α for the Luganda and English versions were 0.78 and 0.86 based on standardized items while Guttman's lambada 2 and 3 were 0.89 and 0.79 respectively. A translated Luganda version of OMDQ MTS is reliable and easy to understand. Thus, it has the potential in being used to monitor mucositis among patients undergoing chemotherapy.
Objective: To measured and compared health-related quality of life (HRQOL) among hypertensive (HYP) and human immunodeficiency virus (HIV) patients at tertiary health facilityDesign: Comparative cross-sectional study.Setting: The medical outpatient clinic of the University of Port Harcourt Teaching Hospital in Nigeria.Subject: Systematic recruitment of 300 HYP and HIV patients; self-reported assessment of the HRQOL using the WHOQOL-BREF questionnaireMain outcome measures: HROQL along domains of the WHOQOL-BREF questionnaire – general, physical health, psychological health, social and environmental health.Data analysis: Exploratory and confirmatory data analyses were conducted using Statistical Package for Social Science version 23 and p-value ≤ 0.05 were considered significant.Result: Response rate was 98% and Cronbach’s alpha was 0.882. About 29.3% and 24.7% reported poor HRQOL for HYP and HIV patients respectively. The mean differences in the HRQOL between HYP and HIV patients along physical, psychological, social, environmental domains and overall HRQOL were physical -15.3(95%CI: -17.2, -13.4, p<0.0001); psychological -17.0(95%CI: -18.9, -15.1, p<0.0001); social 4.2(95%CI: -1.0, 7.4, p = 0.01); environmental -12.6(95%CI: -15.1, -10.1, p<0.001) and overall HRQOL -10.0(95%CI: -11.9, -8.1, p<0.001) respectively. Except for the general health and social domains, HIV patients reported significantly better HRQOL than patients with hypertension.Conclusion: The HRQOL of hypertensives was poorer than HIV patients in most domains of the WHOQOL-BREF instrument. Findings call for more clinical, social and environmental support for all patients with LTMCs especially those with non-communicable diseases like hypertension who currently enjoy no subsidy. Key words: Health-Related Quality of Life, HRQOL, WHOQOL-BREF, hypertension, human immunodeficiency virus patients, HIV, tertiary hospital, UPTH.
Background: Allergic disease is preceded by development of a sensitized state against allergens, characterized by production of allergen-specific immunoglobulin (sIgE) in serum.Objectives: To determine the frequency and patterns of sensitivity to food and inhalant allergens among children.Methods: A retrospective study conducted at Gertrudes Children’s Hospital in Nairobi, Kenya. Laboratory data for sIgE antibodies for the period between January 2014 and December 2017 were retrieved and analysed. Serum sIgE ≥0.35 kU/L indicated sensitization. Descriptive statistics were used to summarize continuous data as median (interquartile range), and categorical data as absolute and relative (%) numbers.Results: 642 sIgE test results were retrieved; 509 (79.3%) against food allergens and 133 (20.7%) against inhalant allergens. Median age of patients evaluated for food allergen sensitization was 3.0 (1 – 6) years; approximately half (50.7%) were males. 242 children (47.5%) were sensitized to at least one food allergen. The most frequently sensitizing foods were milk (17.5%), wheat flour (14.7%) and potato (12.6%). Median age of patients evaluated for inhalant allergen sensitization was 4.0 (2 – 8) years, with a slight preponderance of males (51.1%). 64 children (48.1%) were sensitized to at least one aeroallergen. The most frequently sensitizing aeroallergens were Dermatophagoides pteronyssinus (30.8%), Dermatophagoides pteronyssinus (24.8%) and grass pollen (12.8%).Conclusions: Milk, wheat, potato, house dust mites and grass pollen were the most common food and aeroallergens encountered among children at a private children’s hospital in Kenya. Further studies are needed to clarify the relationship between serum sIgE levels and clinical manifestations of allergic disease locally.
Background: Acute Appendicitis is one of the commonest surgical emergencies worldwide. The incidence in age, sex and relation to seasons of the year show wide variations globally.Objective: to ascertain if there is a seasonal variation in the incidence of acute appendicitis in Aba, Southeast Nigeria, using 3 Hospitals.Design: Prospective study.Setting: Abia State University Teaching Hospital, Jonex Hospital, Living Word Mission Hospital- all in Aba, Southeast Nigeria.Subjects: patients with clinical and histological diagnosis of acute appendicitis at the Abia State University Teaching Hospital, Aba, Living Word Mission Hospital and Jonex Hospital in Aba, Southeast Nigeria. These patients were recruited into this 5- year prospective study which spanned from January 2014 to December 2018. The date of admission, biodata, clinical diagnosis and histological diagnosis were captured in a proforma designed for the study. Results were analyzed using SPSS Programme Version 21 and presented in tables and figure.Results: Three hundred and twenty-one cases of acute appendicitis were seen during this period. 55% were males. There was a steady increase in the incidence of acute appendicitis over the years. In each of the years, the highest incidence was between November and March.Conclusion: This study shows a monthly variation in the incidence of appendicitis in Aba, with higher incidence in the warm and dry months of the year and lower incidence in the wet and humid months of the year.
Background: Community participation is the collective involvement of local people in assessing and identifying their needs, implementing and evaluating health programs. Community projects project have various phases, assessment, planning, implementation, and monitoring and evaluation phase. Community members should be involved in all phases to own the projects. This study sought to establish the level of community participation in Kangundo Sub-county in rural health care facility services, in Machakos County, Kenya.Methods: Analytical cross-sectional study design was used for this study. 384 respondents from Kakuyuni Location were involved in the study. Structured interviewer administered questionnaireResults: The study found out that most of the community members (n=278, 72.4%) were not involved in any stage of development in community project development cycle in rural health care facility services. As per the results 106 respondents had participated in various stages of project development cycle. Again, 15.4%, (n=59) of the respondents were involved in needs assessment, 9.4% (n=36) at implementation stage. 1.6% (n=6) at monitoring and evaluation, and 1.3% (n=5) were involved in all the stages of development cycle. However, most 72.4%, (n=278) of the respondents were not involved at any stage of development. Some factors were significantly affecting community participation; being a county committee member, length of stay in the community and having attended an NGO meeting and community mobilization. Several challenges affected community participation.Conclusion: Kakuyuni community members are less involved in rural health care facility projects, whereby the results revealed that only 27.6% of the interviewed population was involved.
Eccrine Porocarcinoma (EPC) is a rare malignant tumour of the eccrine gland that occurs predominantly in the elderly. We report a 23-year-old female who had a slowly growing lump in the left thigh for 8 months. It spontaneously ruptured and had serosanguinous discharge. The mass was warm, tender and measured 10x6x4cm. A missed diagnosis of subcutaneous abscess was made for which she had incision and drainage. This resulted in a non-healing ulcer. The excision biopsy of the ulcer came out to be EPC. This case highlights the need to maintaining a high index of suspicion for rare tumors like EPC.
Objective: The aim of this study was to determine the effect of HIV-1 genetic variants and drug resistance-associated mutations (DRM) on the development of hepatotoxicity. Design and participants: This was a longitudinal study of 81 newly diagnosed HIV-infected individuals in five HIV Treatment clinics in the Northwest Region (NWR) of Cameroon from February 2016 to November 2016. Methodology: Eighty-one antiretroviral drug-naive patients were recruited into the study and followed-up for 6 months. Blood samples were collected prior to ART initiation and 180 days (D180) later. Serum levels of aminotransferases were analyzed by enzymatic methods. The HIV-1 protease and reverse transcriptase sequences were obtained using an in-house protocol and DRMs were identifiedusing the Stanford HIVDR interpretation program, and HIV-1 subtypes by phylogeny. Results: The mean age of the study participants was 36.5 years. Of these, 37(45.7%) patients showed hepatotoxicity at D180. There were four pure subtypes and five recombinant types with CRF02_AG (74.1%) being the predominant genetic variants. The prevalence of hepatotoxicity was highest among individuals infected with HIV-1 CRF02_AG (70.3%). The prevalence of DRM was 11.1% (9/81). Hepatotoxicity was significantly (p =0.04) higher 77.8% (7/9) among patients with resistant virus. Conclusion: Data from this study reveals a high level of hepatotoxicity among patients with DRM probably as a result of persistent viral replication. These findings highlight the need to conduct routinely DRM surveillance among patients with hepatotoxicity in order to improve patient management and care.
Background: Anemia is common among hospitalized patients, but data particularly on prevalence and classification are sparse for Tanzania. Documented data on these characteristics can help in better planning of admission procedures, blood bank and hospitals´ management. Objective: Prevalence and classification of anemia in hospitalized patients at KCMC. Design: Cross-sectional hospital-based study. Setting: Medical Ward of the zonal referral hospital KCMC, located in Northern Tanzania. Participants: All patients admissions to the Medical Ward at KCMC from October 2018 to March 2019.Main outcome measures: Hemoglobin (Hb) levels, Mean Cell Volume (MCV) (microcytic, normocytic and macrocytic). Materials and methods: Hb levels and MCV were evaluated at admission. Questionnaires obtained socio-demographic and clinical data. Multi-variate logistic-regression analysis was applied to determine associated factors. Results: 399 participants with 55.1% females, mean age of 55.5 years, 77.2% from rural areas. Prevalence of anemia was 44.4%. Younger age groups (25-44 years) had the highest prevalence (52.6% and 51.9%) and 50.5% of female and 36.9% of male patients had anemia. Most common anemia was normocytic anemia (83.1%). Comorbidities with the highest percentage of anemia were HIV positivity (62.9%) and malignancies (61.9%), followed by CKD (60%), chronic liver diseases (45.5%) and heart failure (28.6%). Conclusion: Anemia is common among young, hospitalized patients whereby normocytic anemia is most common and should prompt the focus on kidney failures, malignancies and other non-communicable diseases that are likely to play leading roles in etiology. Further studies are needed to confirm the link of anemia and NCD´s among hospitalized patients in Tanzanian
Background: Approximately 50% of cervical cancer cases are diagnosed in women who have not been screened previously. It has been observed in some centres that co-testing with LBC and HR-HPV identifies those with current precancerous lesions and those with an active HR-HPV for management. The procedure has not been examined in our setting so as to enable consideration for use in the diagnostic process.Objective: To determine LBC and HR-HPV findings in women over 29 years old who had no previous screening for cervical cancer at Cimas MEDLABS.Design: Cross sectional descriptive studyMaterials and Methods: Women with no prior history of cervical screening were recruited into this study. A Thin Prep 2000 machine was used process the LBC specimens. The 2014 Bethesda System was used to report the smears. HR-HPV DNA testing was done using the Cepheid Xpert HPV qualitative test.Results: There were 1446 co-tested specimens; the mean (SD) age of study participants was 38.7 (8.3) years and the range was 30-79 years. Tests results showed the following: NILM/HPV- (n=1149, 79.5%), NILM/HPV+ (n=265, 18.3%), ≥ ASCUS/HPV+ (n=23, 1.6%), ASCUS/HPV- (n=9, 0.6%). The ≥ ASCUS lesions were distributed as follows: ASCUS = 25, LSIL = 6 and HSIL = 1. The co-testing approach identified 297 (20.5%) women with a higher risk of developing cervical cancer (≥ ASCUS and HPV+ patients) for follow up according to established protocols.Conclusion: Approximately a fifth (20.5%) of unscreened women had either a precancerous lesion or an active HR-HPV infection and required follow.
Objective: To evaluate the place of ultrasound-guided TAP block in the management of post-appendicectomy pain.Design: Randomized, double blind comparison of Transversus Abdominis Plane block against administration of normal saline for the management of post appendicectomy pain.Setting: University of Benin Teaching Hospital; a university-affiliated tertiary centre in Nigeria.Subject: Seventy-two (ASA I or II) patients scheduled for appendectomy.Interventions: Eligible patients were randomized to receive 20ml of 0.25% plain bupivacaine or 20ml of 0.9% saline for ultrasound-guided unilateral TAP block. Spinal anesthesia was achieved using a combination of 0.5% hyperbaric bupivacaine (15mg) and pethidine (10mg).Main Outcome Measure: The proportion of patients with NRS scores of ≤ 3 at the 4th hour postoperatively.Results: The proportion of patients who required analgesic at the second hour was none in the TAP-LA while 12 patients (33.3%) in TAP-S had pain (P < 0.0002). At the fourth hour, no patients in group TAP-LA requested for analgesic as against 36(100%) in group 2 (p < 0.0001). The time to first analgesia request was 477.14±216.33 minutes in group TAP-LA and 160.17 ±37.42 minutes in group TAP-S (P < 0.0001). The total paracetamol (p = 0.0001) or tramadol (p = 0.0001) consumption in 24hours was higher in the TAP-S group than the TAP-LA group.Conclusion: Ultrasound guided unilateral TAP blocks with bupivacaine resulted in decreased NRS scores up to the postoperative 6th hour, prolonged time to first analgesic request and decreased analgesics consumption compared to the standard of care in our hospital.
Objective: Street cleaners are unprotected from a range of health hazards in their day-to-day activities of removing harmful pollutants from the streets. The main aim of this study was to assess the level of awareness and factors associated with exposure to occupational health hazards among street cleaners in Eldoret Town, Uasin Gishu County.Setting: The study was conducted in Eldoret town, Uasin Gishu County.Design: The study adopted a cross sectional survey research design.Participants: The study’s participants were street cleaners. Since the target population was small, census design was adopted. Data were collected using questionnaires. Data analysis was done using both descriptive and inferential statistics.Results: The study targeted 70 street workers who all of them participated in the study. This gave a response rate of 100%. Study results revealed that 55(78.6%) of the respondents were exposed to health hazards daily. Further, majority 52(74.3%) of street cleaners were not aware of administrative procedures regarding the management of hazard exposure. In addition, 55(78.5%) of street cleaners are not aware of well-developed preventive maintenance programs. The main factor associated with exposure to hazards is level of education (ꭓ2=21.417, df=8, ‘p=0.000).Conclusions: The study concluded that the level of awareness on health hazards and prevention measures among street cleaners in Eldoret town, was low. The level of education is associated with exposure to these health hazards. There is need for training of cleaners on the personal protective equipment usage and its importance so as to promote awareness and reduce occupational hazards
Objective: To establish breastfeeding practices among mothers with new-born babies attending Kenyatta National HospitalDesign: The study adopted a mixed methods cross sectional design using qualitative and quantitative methodsSetting: Kenyatta National HospitalSubjects: Mothers with new-born babies attending postnatal clinic and pediatric unit at Kenyatta National HospitalMain outcome measures: Demographic characteristics and breastfeeding practicesResults: Slightly above half 51.5% (n=103) of the respondents had good breastfeeding practise while 48.5% (n=97) had poor breastfeeding practices. Age (OR=2.8, 95% CI 1.3 – 5.4, p=0.008), level of education (OR=2.4, 95% CI 1.6 – 4.1, p=0.011) and antenatal care initiation (OR=3.4, 95% CI 2.3 – 5.9, p=0.011) were significant.Conclusion: Although breastfeeding initiation was poor, majority of the women breastfed on demand and had good body positioning and emotional bonding during breastfeeding. Health education given to mothers in antenatal care should therefore emphasise that mothers initiate breastfeeding immediately after birth.
Background: Depo-medroxyprogesterone acetate is a highly effective injectable contraceptive. Weight gain is a commonly reported side effect that makes women to discontinue the contraceptive method. Studies on weight changes among the users in Nigerian women are sparse. Hence, this study was aimed at determining the effect of Depo-medroxyprogesterone acetate on the weight and Body Mass Index of users at 6 months and 12 months.Methods: This was a prospective longitudinal study conducted among sixty-eight new acceptors of Depo-medroxyprogesterone at the family planning clinic of Olabisi Onabanjo University Teaching Hospital Sagamu, Ogun State. Weight and Body Mass Index of acceptors were recorded. Women were followed up at 6months and 12 months. The data was analysed using SPSS version 24.Results: The mean weight before starting Depo-medroxyprogesterone acetate was 62.9±10.5kg and at 6 months and 12 months the mean weights were 63.3±10.5kg and 63.8±9.8kg respectively. The increase in weight of the participants at 6 months was not significant (t=1.511, P=0.135), however after 12 months, there was significant weight gain (t=2.697, P=0.009). Similarly, Depo-medroxyprogesterone acetate was associated with a non-significant increase in Body Mass Index at 6 months (t=1.455, P=0.150) whereas users had statistically significant increase in Body Mass Index at 12 months post-commencement. Age, parity, educational status and pre-treatment Body Mass Index of study participants were not predictors of weight gain among Depo-medroxyprogesterone acetate users.Conclusion: Depo-medroxyprogesterone acetate was associated with significant weight gain and Body Mass Index increase after 12 months of use. Appropriate counselling is important prior to initiation
Objective: This study explored the perspectives of foundational science teachers on the integration of courses within a discipline-based curriculum.Design: A qualitative enquiry based on an interpretive paradigm framework. Data were obtained through three focus group discussions conducted among the teachers from the departments of anatomy, physiology, and biochemistry of the institution. The transcript data obtained were analysed using the process of thematic analysis.Setting: The study was conducted in the College of Health Sciences, Obafemi Awolowo University Ile-Ife, (CHS, OAU) Nigeria.Participants: All twenty-six foundational science teachers were invited to participate in the discussion, but only twenty-one participated in the study.Result: The perspectives of the foundational teachers were grouped into four themes upon agreement by the authors. The themes were: (1) knowledge of integration, (2) perception of the need for and benefits of integration, (3) enablers and barriers to integration, and (4) suggestions. Participants believed integration was necessary to foster a better understanding of courses and would encourage interdisciplinary teaching. They also believed integration would reduce curriculum overload in basic medical science courses. Several logistic issues were perceived as barriers.Conclusion: This study revealed that the teachers support the integration of courses in the curriculum to enhance teaching while encouraging students’ participation and understanding. Full understanding and commitment of teachers are necessary for the effective integration of the curriculum. Institutional and infrastructural support is required for the success of such a proposed curriculum.
Objective: To investigate factors associated with occurrence of unwanted pregnancies and uptake of sexual and reproductive health information and services.Design: Cross sectional descriptiveSetting: Students’ hostels University of Nairobi.Subjects or participants: Students of University of Nairobi.Interventions: Focus group discussionMain outcome measures: Health issues; Unwanted pregnancies; Information on RH and abortion.Results and conclusion: On health problems, STIs, HIV/AIDS, alcohol and drug abuse were mentioned. On unwanted pregnancies, these were common and were generally terminated. Methods of termination mentioned included drinking concentrated tea leaves and other concoctions, overdosing with tablets from the chemist and taking misoprostol. On information on RH and abortion the requested information was on sexuality and not abortion. On sources of the information, the university clinic and academic sources were mentioned. On persons providing information and support to students, student leaders, the university clinic and lecturers were the preferred. Main barriers to receiving information from the school clinic included negative attitudes and poor practices of nurses. An assessment of the health problems facing the students be done and services structured to be responsive to the problems. Multidisciplinary fora for discussing sexual and reproductive health matters be set up. A retraining and reorientation of university health workers in particular the nurses be done periodically
